A total of 118 patients (138 knees) who received total knee arthroplasty at the Department of Orthopedics, Guizhou Province People's Hospital between June 2000 and January 2007 were included in this study. These patients comprised 45 males and 73 females and were averaged (61±8) years old (range, 52-81 years). Of them, 28 (34 knees) suffered from rheumatoid arthritis, 6 (6 knees) from traumatic arthritis, 84 (98 knees) from severe osteoarthritis, 14 (18 knees) complicated by extraversion, and 25 (28 knees) complicated by inversion. Link Gemini knee prosthesis was used in 38 knees, Zimmer Nexgen knee prosthesis in 68 knees, and Depuy pfc sigma rotation platform knee system in 32 knees. All patients were followed up for an average of 28 months (range, 10 months-6 years). Prior to replacement, the mean knee score, according to the Hospital for Special Surgery (HSS) rating scale, was (34.00±7.65) points, and at the latest follow-up examination, it was (81.00±6.89) points. HSS score was excellent in 87 knees (63%), good in 43 knees (31%), and fair in 8 knees (6%). The excellent and good rate was 94%. Of 118 patients, 4 presented with infection and 3 showed deep venous thrombosis in lower limb following unilateral total knee arthroplasty and healed after anticoagulation and symptomatic therapy. There were 3 patients presenting with knee joint pains 2 months following knee joint arthroplasty. No knee joint red swelling and tenderness were found. Range-of-motion was basically normal. X-ray photograph indicated good position of prosthesis. Pains were relieved after femoral nerve block. All these findings suggest that total knee replacement is an effective method of treating severe knee joint diseases. INTRODUCTIONTotal knee arthroplasty (TKA), as an important part of artificial joint replacement for treatment of severe knee joint diseases, initiated from the first knee joint prosthesis developed by Cunstno in 1960s and was put in use. But following TKA, large-scale severe complications appear due to condition limitations, which results in failed surgery. With development of molecular biology and materials, as well as further research of installing technique and knee joint biomechanics, TKA has been shown to be gradually perfect theoretically. A novel prosthesis better corresponds to the physiological standards of human body in terms of structure design, material strength, and shape. These improvements greatly enhance prosthesis survival rate and markedly decreases complication incidence following TKA. TKA has been shown to be an efficient method of treating severe knee joint diseases. It can effectively relieve joint pains and improve joint functions, and is mostly used in elderly populations (over 60 years old) who complicated by other diseases, such as diabetes mellitus, hypertension, heart disease, phlebitis of lower extremities. In addition to above-mentioned, poor body resistance enhances surgery risk and difficulties, and complications would be correspondingly increased following TKA. The present study retrospectively analyzed a total of 118 patients with severe knee joint diseases who underwent TKA at the Department of Orthopedics, Guizhou Province People's Hospital between June 2000 and January 2007.

Objective:To evaluate the effects of erythropoietin (EPO)on the proliferation and osteogenic differentiation of human dental pulp cells(hDPCs)in vitro.Methods:Isolated hDPCs were cultured and identified.The cells were treated by EPO and the proliferation of the cells was determined by CCK-8 assay.After incubation with EPO at 20 U /ml in osteogenic induction medium for 7 and 1 4 days,the mineralization of hDPCs was observed by alkaline phosphatase (ALP)activity assay and alizarin red staining.Real-time PCR was utilized to detect the expression of odontogenesis-related genes.Results:EPO enhanced the proliferation of hDPCs in a time-and dose-dependent manner.After treatment with EPO,ALP activity and the minerialized nodes of the cells increased(P <0.05);the expression levels of odontogenesis-related genes DSPP,OCN,OSTERIX and RUNX2 were upregulated(P <0.05).Con-clusion:EPO can promote proliferation and differentiation of human dental pulp cells.

Objective To investigate the relationship between serum uric acid level and the severity of pregnancy induced hypertension (PIH) in pregnant women with hypertension.MethodsFrom January 2016 to July 2016 in our hospital for treatment of 100 cases of patients with pregnancy induced hypertension, as PIH group, divided into severe hypertension group (33 cases), moderate PIH group (33 cases) and mild PIH group (34 cases), then select 100 cases of normal pregnant women normal pregnancy group.The serum uric acid levels were measured and the results were analyzed.ResultsThe average serum uric acid levels in PIH group (359.75+89.23) mol/L was significantly higher than the control group (188.24+54.54) mol/L in PIH group, the average level of serum uric acid in severe, moderate and mild degree is decreasing, respectively (449.32+81.11), (352.89+76.41), (288.76+59.58) mol/L, a statistically significant difference between the groups (P<0.05).ConclusionThe detection of serum uric acid level in pregnant women can effectively determine the degree of pregnancy induced hypertension in pregnant.

From 101 records relating to health kept in the National Archives of Malaysia for the period 1946–1981, 30 records were chosen using purposive criterion-based sampling on dimensions of universal health coverage (UHC) and health system governance. From those 30, document review was performed on 13 records that were selected based on relevance to analysis of the evolution of private and public health institutions and their roles in achieving UHC from 1946 to 1981. UHC relates to the ability of patients to access good quality service with high population coverage of health care at low financial risk. Malaya was a former Western Pacific nation ruled by the British colonial government. Initially, the government bore the cost of medicines and passages between the United Kingdom and Malaya for Red Cross and St. John’s ambulance teams to serve in rural areas in Malaya. This was later replaced by home grown Rural Health Teams trained in purpose built Rural Health Centres beginning with the first such training school in Jitra under the Rural Health Scheme. The Rural Health Scheme was implemented from 1953 to 1956 and marked an ambitious period of utilising limited resources to expand human resource and establish District Health Centres, Sub-District Health Centres, Midwives’ Houses and Maternal and Child Health Centres across the rural landscape of Malaya. After analysis, it was found that the British colonial government’s efforts in improving public health through the Rural Health Scheme had provided the foundation for achieving UHC in Malaysia today.

Background The studies on intravitreal ranibizumab for diabetic macular edema (DME) primarily focuses on the absolute change of central retinal thickness, while the affection of the relative change of central retinal thickness (RCRT) or relative change of central retinal thickening (RCRTing) on visual prognosis has not been elucidated completely.Objective This study aimed to evaluate the effect of RCRT and RCRTing in assessing visual prognosis in DME patients following intravitreal injection of ranibizumab.Methods A self-controlled observational study was designed.Thirty eyes of thirty patients with clinically significant DME (CSDME) were recruited in Beijing 401 Hospital of China Nuclear Industry from November 2013 to October 2014.Ranibizumab of 0.05 ml (10 mg/ml) was intravitreally injected by 30G syringe needle at 3.5 mm posterior corneal limbus.Best corrected visual acuity (BCVA) far 2.5 meters away modified ETDRs visual chart was examined before injection and 3 and 6 months after injection,and the BCVA difference value between before injection and 6 months after injection was calculated as the absolusion BCVA (ABCVA).Spectral domian optical coherence tomography (SD-OCT) system was employed to measure the central retinal thickness (CRT) and to calculate the RCRT and RCRTing value.The correlations of RCRT or RCRTing with ABCVA was analyzed.Results The LogMAR values were (0.66±0.20) ,(0.40±0.25) BCVA and (0.37±0.25) before injection and 3,6 months after injection respectively in the CSDME patients,with a significant difference among them (F =36.79,P＜0.05).The values were obviously improved 3 and 6 months after injection compared with before injection (both at P＜0.05).The mean ABCVA (LogMar) of the patients was (0.30±0.21).The CRT 3,6 ,pmyjd sgyrt omkrvyopm values were (508.63±130.44), (331.07±71.84) and (311.77±64.47)μm before injection and respectively in the CSDME patients, showing a significant difference among them (F=49.78,P＜0.05).The CRT values were evidently reduced 3 and 6 months after injection in comparison with before injection (both at P＜0.05) ,and the mean ACRT value was (196.87±140.59) μm.The ABCVA values were (0.13±0.13),(0.44±0.14),(0.07±0.09) and (0.41±0.15) LogMAR in the RCRT＜35％ group,RCRT≥ 35％ group,RCRTing＜69％ group and RCRTing ≥ 69％ group, respectively.Significant differences were found in ABCVA between the RCRT＜35％ group and RCRT≥35％ group (t=-6.27,-8.65,both at P＜0.05).RCRT and RCRTing showed the positive correlations with ABCVA in the CSDME patients (r =0.86,0.79, P ＜ 0.05).Conclusions RCRT and RCRTing can identify well the optimal responders to intravitreal ranibizumab and predict BCVA improvement after treatment.RCRT has better association with ABCVA than RCRTing.RCRTing may be preferable when retinal thickening is more severe.

Objective To investigate the effects of continuous nursing quality improvement on emergency care of parturient with preeclampsia.Methods The parturient with preeclampsia in the First Affiliated Hospital of the Medical University Of Anhui from January 2010 to December 2015 were chosen.The effects of continuous nursing quality improvement on the emergency care of those parturient were analyzed and the maternal and infant health outcomes and patient satisfaction were contrasted.Results The surgical complication rate of the observation group patients was significantly lower than that of the control group (P＜0.001).The overall health outcome of maternal and infant patients in the observation group was significantly better than that of the control group (P＜0.000) Patient satisfaction of the observation group was significantly higher than that of the control group (P＜0.000)Conclusion Continuous nursing quality improvement model can not only ensure the quality of eclampsia patient care but also keep on improving the care quality so as to improve maternal and infant health outcomes and patient satisfaction.

The Roles of the clinicians in different medical models are quite different,which not only led to the change of the relationship between the clinicians and the patients, but also had a significant clinical effect. The authors compared the clinicians'role in different medical models and showed the humanism underlying this change.

Stage Ⅲ A non-small cell lung cancer (NSCLC) has high heterogeneity and there are some controversies over the treatment of this disease,especially for patients with stage ⅢA-N2 NSCLC.This article investigates whether preoperative or postoperative radiotherapy can improve the survival of patients with stage ⅢA-N2 NSCLC and evaluates the effect of surgical treatment.

Vitrectomy combined with internal limiting membrane (ILM) peeling and vitreous tamponade is a conventional method for treating macular hole (MH),but the visual acuity and MH closure rate remains to be further improved.After removal of posterior vitreous cortex,the ILM is grasped with an ILM forceps and peeled off in a circular fashion for approximately 1 disc diameters around the MH.During the circumferential peeling,the ILM is not removed completely from the retina but is left attached to the edges of the MH.The ILM was then massaged gently over the MH from all sides until the ILM became inverted and then peel all other ILM within vascular arcades.Inverted ILM flap technique is one of the important improvement methods in MH vitrectomy,especially for MH with large diameter and unhealed MH after ILM peeling.Compared with conventional vitrectomy combined with ILM peeling,inverted ILM flap technique can enhance MH closure and improve visual acuity.Due to lack of large sample observation in clinical trials of inverted ILM flap technique,we still need more cases and longer follow-up of this technology to more accurately evaluate the effectiveness and safety of this technique.